Australia suffered greatly from the effects of bubonic plague in the first two decades of the 20th century. The Australian colonial government had been wary of plague arriving in Sydney via shipping trade routes since the 1894 outbreak in Hong Kong. When plague did reach Australia in 1900, the response was one of panic and dread, fuelled by the knowledge of the history and ravenous potential of the disease. Many medical practitioners and scientists still believed the disease was essentially a human infection and spread through human contact with the infected. However, health authorities were aware of the building evidence that plague epidemics were associated with an epizootic infection in rats and began to incorporate preventative strategies to prevent its entry through the ports.

Despite this effort, bubonic plague reared its ugly head in Sydney on 19 January 1900. Australia's first victim was Arthur Paine, a 33 year old delivery man whose daily work brought him into contact with Central Wharf. The diagnosis was made by Dr Sinclair Gillies, an honorary assistant physician at the Royal Prince Alfred Hospital.

There were 12 major plague outbreaks in Australia between 1900 and 1925 as ships imported wave after wave of infection. Government health archives record 1371 and 535 deaths. Sydney was hit hardest, but the disease also spread to North Queensland while more sporadic cases were documented in Melbourne, Adelaide and Fremantle.

Chief Medical Officer, John Ashburton Thompson, appointed Sydney Medical School graduates to build a fledgling public health department. Frank Tidswell (MB ChM 1892) was appointed Bacteriologist and William George Armstrong (MB ChM 1888) and Robert Dick (MB ChM 1892) were appointed as Medical Officers to the City of Sydney. Thompson, Armstrong and Tidswell went on to produce outstanding research on plague and are credited with developing 20th century scientific understandings of plague, in particular that Yersinia pestis is spread to humans by fleas from infected rats. Their work was a large part of a revolution of social medicine in Australia. The knowledge that infectious diseases could be spread from one human to another by insects and that infection could be derived from animals, brought public health into scientific scrutiny. The outbreak also led to further improvements being made to our Quarantine Station as the value of segregating infected patients from the populace had been greatly realised.

Another Sydney Medical School graduate met an untimely death working towards the eradication of plague. Thomas Carlyle Parkinson was one of the 32 medical students who graduated MB ChM in 1906. They had experienced the impact of plague outbreaks in Sydney in 1901-2 so it is not surprising that when Parkinson went to London to broaden his experience he chose to join C.J. Martin’s team at the Lister Institute where work on improved plague vaccine was a major preoccupation. Martin had taught in the Department of Physiology in Sydney before moving to Melbourne in 1897, and then returning to Britain as Director of the Lister Institute in 1903 where he made opportunities for many young Australian graduates.

In 1909 Parkinson was working at the Lister’s Isolation Laboratory at Elstree with Sidney Rowland, a bacteriologist who had been seconded to the Indian Plague Commission. The project involved growing large quantities of plague bacillus then grinding it before extraction by chemical treatment. The dangers of this technique were well recognized: there had been two deaths from typhoid at the Lister in 1903. Parkinson contracted pneumonic plague and died three days after contracting the illness. A prize in the Department of Pathology commemorates his death.